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http://dx.doi.org/10.14475/kjhpc.2015.18.2.136

Effects of Integrated Palliative Care Intervention on Quality of Life in Terminal Cancer Patients: A Meta-analysis  

Jo, Kae Hwa (College of Nursing, Catholic University of Daegu)
Park, Ae Ran (Graduate School, Catholic University of Daegu)
Lee, Jin Ju (Graduate School, Catholic University of Daegu)
Publication Information
Journal of Hospice and Palliative Care / v.18, no.2, 2015 , pp. 136-147 More about this Journal
Abstract
Purpose: This study was conducted to evaluate the effects of integrated palliative care intervention on quality of life in terminally ill patients. Methods: A comprehensive literature search was performed via PubMed, Cochrane Library CENTRAL, LWW (Ovid), CINAHL and several Korean databases. The main search strategy was to combine terms indicating palliative care intervention, presence of terminal illness and study design. Methodological quality was assessed using Cochrane's Risk of Bias for randomized studies and Risk of Bias Assessment tool for non-randomized studies. Data were analyzed by the Stata 10 program. Results: Eight clinical trials met the inclusion criteria with a total of 356 participants. Integrated palliative care interventions were administered for a mean of 6.5 weeks, 5.6 sessions and an average of 47.8 minutes per session. Effect sizes were heterogeneous, and subgroup analysis was done. Integrated palliative care interventions had a significant effect on quality of life (ES=1.83, P=0.018, $l^2=92%$), spiritual well-being (ES=0.78, P=0.040, $l^2=0$), depression (ES=0.86, P<0.001, $l^2=32$) and anxiety (ES=0.69, P=0.041, $l^2=71.1$). But integrated palliative care interventions had no significant effect on pain (ES=0.365, P=0.230, $l^2=69.8$). Conclusion: Results support findings that integrated palliative care interventions were helpful in lessening depression and anxiety and improving quality of life and spiritual well-being, however, the interventions did not assist pain management in terminal cancer patients. These findings suggest that various integrated palliative care interventions can assist terminal cancer patients with better quality of life in the socio-psycho-spiritual dimension.
Keywords
Palliative care; Terminally ill; Quality of life;
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Times Cited By KSCI : 3  (Citation Analysis)
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1 Wein S, Sulkes A, Strmmer S. The oncologist’s role in managing depression, anxiety, and demoralization with advanced cancer. Cancer J 2010;16:493-9.   DOI
2 Kolva E, Rosenfeld B, Pessin H, Breitbart W, Brescia R. Anxiety in terminally ill cancer patients. J Pain Symptom Manage 2011;42:691-701.   DOI
3 Ando M, Morita T, Akechi T, Okamoto T; Japanese Task Force for Spiritual Care. Efficacy of short-term life-review interviews on the spiritual well-being of terminally ill cancer patients. J Pain Symptom Manage 2010;39:993-1002.   DOI
4 Chung JS. Effects of spiritual nursing care on spiritual wellbeing, depression, anxiety and pain in terminal patients with cancer [dissertation]. Gwangju: Chonnam National Univ.; 2005. Korean.
5 Min YC, Oh PJ. A meta-analysis of intervention studies on cancer pain. J Korean Oncol Nurs 2011;11:83-92.   DOI
6 Lee TW, Lee MH, Kim MS. Comparison of the costs of care and nursing services for terminally ill patients receiving home hospice care in comparison to institutional care. J Korean Acad Nurs 2000;30:1045-54.   DOI
7 Tae YS. The relationship between hope and quality of life of cancer patients. J Korean Acad Adult Nurs 1996;8:80-92.
8 Penson J. A hope is not a promise: fostering hope within palliative care. Int J Palliat Nurs 2000;6:94-8.   DOI
9 Park MY. The perceived causal structure model on women's anger with breast cancer [dissertation]. Daejon: Chung Nam Univ.; 2003. Korean.
10 Jo KH, Han HJ. Nurses' painful experiences through terminal patient. J Korean Acad Nurs 2001;31:1055-66.   DOI
11 Carlson LE. Bultz BD. Mind-body interventions in oncology. Curr Treat Options Oncol 2008;9:127-34.   DOI
12 Wilkinson SM, Love SB, Westcombe AM, Gambles MA, Burgess CC, Cargill A, et al. Effectiveness of aromatherapy massage in the management of anxiety and depression in patients with cancer: a multicenter randomized controlled trial. J Clin Oncol 2007;25:532-9.   DOI
13 Dunwoody L, Smyth A, Davidson R. Cancer patients' experiences and evaluations of aromatherapy massage in palliative care. Int J Palliat Nurs 2002;8:497-504.   DOI
14 Padilla GV, Ferrell B, Grant MM, Rhiner M. Defining the content domain of quality of life for cancer patients with pain. Cancer Nurs 1990;13:108-15.
15 Gray RA. The use of massage therapy in palliative care. Complement Ther Nurs Midwifery 2000;6:77-82.   DOI
16 Byun YJ, Eun CS. Psychological stress in chronic intestinal diseases. Hanyang Med Rev 2014;34:66-71.   DOI
17 Myklebust M, Pradhan EK, Goreflo D. An integrative medicine patient care model and evaluation of its outcomes: the University of Michigan experience. J Altern Complement Med 2008;14:821-6.   DOI
18 Higgins JP, Thompson SG, Deeks JJ, Altman DG. Measuring inconsistency in meta-analyses. BMJ 2003;327:557-60.   DOI
19 Egger M, Davey Smith G, Schneider M, Minder C. Bias in meta-analysis detected by simple, graphical test. BMJ 1997;315: 629-34.   DOI
20 Ferrell BR, Coyle N. Textbook of palliative nursing. 2nd ed. Oxford:Oxford University Press:2006.
21 Hwang MS, Ryu HS. Effects of a palliative care program based on home care nursing. J Korean Acad Nurs 2008;39:528-38.
22 Oh PJ, Lee EA. Cognitive behavioral therapy for psychological distress, self care and quality of life in patients with cancer; a meta-analysis. Korean J Adult Nurs 2013;25:377-88.   DOI
23 Goedendrop MM, Gielissen MF, Verhagen CA, Bleijenberg G. Psychosocial intervention for reducing fatigue during cancer treatment in adults. Cochrane Database Syst Rev 2009;(1): CD006953.